High Tg/HDL-Cholesterol Ratio Highlights a Higher Risk of Metabolic Syndrome in Children and Adolescents with Severe Obesity

Abstract

Few data are currently available on the reliability of the different anthropometric, instrumental and biochemical indexes in recognizing the presence of metabolic syndrome (MetS) in children and adolescents with severe obesity. Therefore, the objective of our study was to find out the simplest and most accurate predictive index of MetS in this population at-risk. In 1065 children and adolescents (563 f, 502 m), aged 14.6 ± 2.1 years (range 10–17), with severe obesity [BMI-SDS 3.50 ± 0.36 (range 3.00–5.17)], the following indexes were evaluated: BMI, BMI-SDS, Tri-Ponderal Mass Index, Waist-to-Height ratio, TG/HDL-Cholesterol ratio, Cardiometabolic Index (CMI), and Visceral Adiposity Index (VAI). For each subject, all the components of MetS, defined according to the IDF criteria, were determined. Overall, the presence of MetS was found in 324 patients (30.4%), 167 males (33.3%) and 157 females (27.9%). According to the ROC analysis, three indexes (VAI, CMI and TG/HDL-Cholesterol ratio), performed significantly better than the other ones in identifying MetS, with no difference among them. In conclusion, the TG/HDL ratio, which just needs the evaluation of two simple biochemical parameters, offers the same accuracy as other more sophisticated indexes in recognizing MetS in children and adolescents with severe obesity, thus making it the best predictor to be easily used.

Triglyceride-to-High-Density-Lipoprotein-Cholesterol Ratio as a Predictor of Metabolic Syndrome According to Stage of Life at Obesity Onset in Women with Severe Obesity—A Pilot Study

“…Although there was no association between the phase of life at which obesity was developed and the presence of MetS, w identified the TG/HDL-c ratio as a simple and promising parameter for identifying th risk of MetS in women with severe obesity. The AUC values obtained (0.84 and 0.9) wer similar to those found in studies with adolescents from Korea and adults from Iran, China and a multiethnic sample, which were, respectively, 0.932, 0.85, 0.815, and 0.87 [10,17,20,21].…”

“…The TG/HDL-c ratio has also been suggested for use in recognizing MetS in children and adolescents with severe obesity [10,11]. As highlighted by Radetti et al (2022) [10], the cutoff for the TG/HDL-c ratio as a predictor of MetS can change over the years, which reinforces the importance of studies evaluating this ratio with the MetS outcome in different age groups. This has raised questions about the relationship between the age of obesity onset and the TG/HDL-c ratio as a risk factor for MetS.…”

“…Considering that IR is an indisputable risk factor for MetS, the identification of another predictive marker for IR can be useful for screening individuals at risk of developing MetS [5]. The triglyceride-to-high-density lipoprotein Obesities 2022, 2 362 cholesterol (TG/HDL-c) ratio is a practical and easy-to-apply test in clinical practice, and different studies have highlighted this ratio as a simple and effective measure for IR identification [6][7][8][9][10][11] and for the risk of cardiovascular events in the general population [12]. The TG/HDL-c ratio was able to identify metabolic abnormalities in eutrophic women [6], IR in individuals with DM1, and be a predictor of DM2 in a cohort of African Americans and Hispanics [8], as well as a predictor of MetS in the elderly Chinese population, highlighting the possibility of its application in different health conditions and ethnicities [9].…”

The neutrophil to lymphocyte ratio (NLR) positively correlates with the presence and severity of metabolic syndrome in obese adults, but not in obese children/adolescents

“…To date,the prevalence of obesity-associated metabolic syndrome (MetS) was reported to be close to 25%—30% in children/adolescents with obesity [ 27 , 29 ], while in adults the prevalence markedly increased up to 60–65% [ 28 , 30 ], indicating thus a progressive age-dependent increase of the altered factors determining MetS. Hence, the importance to find new methods for MetS early identification and prevention.…”

The Lipid Accumulation Product Index (LAP) and the Cardiometabolic Index (CMI) Are Useful for Predicting the Presence and Severity of Metabolic Syndrome in Adult Patients with Obesity

“…For instance, the LAP was very effective in diagnosing MetS in women suffering from polycystic ovary syndrome who have a normal weight or who are overweight [61], in patients with HIV [24], as well as in the healthy adult population [32,62]. Similarly, the CMI was reported to be effective in discriminating between the presence or absence of MetS in adolescents and adult women with obesity [63,64]. Furthermore, the two indexes showed a good correlation between each other and regarding the presence of MetS, while the same correlations were not found with the BAI.…”